1. Early Intervention and Prevention
An Integrated Team
Julia McGowan 2017

2. Introduction The journey from stand alone to Integrated teams
Team Make up
New Roles
Overview of team roles
Asset based approach “Deal for Adult Social Care
Future Developments

3. The Journey
Original Stand alone traditional Equipment and Adaptations Occupational Therapy Team, Reablement service, Assistive Technology team, Sensory rehabilitation team.
First step: Development of Locality Model the OT team moved into 3 localities along with Social care teams.

4. The Journey continued
OT manager seconded to develop integration of OT and Reablement.
The 4 stand alone services became an integrated team one team in each locality
Working closely with Social Workers and Social care officers
Agile working and hot desks

5. Team make up
Service manager OT Niamh Rigby OT Locality Team managers with lead responsibility across the teams for Occupational Therapy. Reablement. Assistive Technology and sensory ICES Moving and handling

6. Locality EI Team Makeup
Team manager
Advanced Practitioner OT
Occupational Therapists
Primary Assessors,
Reablement Team leaders,
Reablement support workers.
1 sensory rehab worker

7. One Front Door
Redesign so that all referrals including requests care were assessed by Early Intervention and prevention
Reablement to reduce the need for care or clearly identify the level of care and support needed following assessment
Equipment and adaptations
Assistive Technology

8. New Roles Developed
Primary Assessor – trained to assess for Reablement, Equipment and Adaptations, Assistive technology. Call in on OT for support when required. Benefits for the person, one assessment no need to refer on reduces multiple waiting list.
Early Intervention Co-ordinator – manages incoming referrals to the locality replacing the multiple duty systems.

9. Brief overview of the other roles
Advance Practitioner OT – some line management and small case Load
Reablement Team leader - Line management of support workers, set up Reablement programmes for Hospital Discharge and community. Manage Rota’s
Occupational Therapist – complex cases and clinical supervision of PA’s and Reablement team Leaders
Support workers – carryout Reablement programmes input feedback into Mosaic.

10. Benefits A streamlined service for the service user.
All people are given the opportunity to improve their Health and well being.
We use an asset based approach
There is a strong emphasis on People pursing full and active lives in their own communities.
Reablement service awarded Outstanding by CQC

11. Wigan Councils Asset Based approach providing services

12. The wider context
The ‘Deal’ for Adult Social Care and Well Being see care as a whole care and support system.
It means people are viewed as unique individuals with assets, gifts and talents, and it liberates you to work in creative and innovative ways

13. The bigger picture Community Knowledge Officers Provider services
Early Intervention, Support, Safeguarding
Different conversations
Exploring options,
Sign posting
Sharing knowledge and ideas
Connecting as and when appropriate
Community Knowledge Officers
Understand what’s out in the community The community Book
Support front line staff
Locality Based
Gather and collate information re gaps in market
Market development officers
Develop solutions to meet the needs and aspirations of Wigan citizens, based on information re gaps
Community connectors and community link workers
A paid Community Link Worker or a volunteer Community Connector can provide buddying support to enable individuals to participate and engage in community opportunities
Provider services
Having different conversations
Developing services in a different way
Partnership working with the community
Enriching the lives of the people we work with

14. The Future Integrated Community services
We are developing and Integrated service that involves
Social care
Early Intervention and prevention
Health Therapists
GP’s
Community Matron’s District Nurses
Daily Huddles and Weekly MDT. Joint approach
Locality based co-location
Complex care – virtual ward
Active care step down – rehabilitation Reablement, adaptations
Prevention including a public health intervention and community engagement.  
Internally progression is two grades of OT.  G9 OT similar to Band 6 with some progression over time and G10 Advance Practitioner similar to a Band 7 which takes on combined clinical caseloads and more line management and developmental. projects.  OT Team Managers and Service Manager. 
Over time we have seconded 5 Primary Assessors to Salford to train as OT’s.
Do feel that if you come into OT in Wigan there is quite a clear pathway.  OT Is highly valued and work ib partnership with Social care.  Some OTs in senior positions.  Become accepted that OTs are good managers.
OT’s have regular peer support /CPD meetings
In new model forming an even more integrated team with NHS therapists and nurses – interesting because they’ve done all that work. Staff now open to change, have identified generic and specialist. 
Done workshop for health colleagues re providing major adapts to avoid duplication and overlap.
prevention and Early Intervention – Use of public health community knowledge officers community